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A study of thyroid function in psychiatric in-patients

D G McLarty, W A Ratcliffe, J G Ratcliffe

    The British Journal of Psychiatry : the Journal of Mental Science
    |September 1, 1978
    PubMed
    Summary

    Thyroid hormone abnormalities, including hypothyroidism and hyperthyroidism, were found in psychiatric inpatients. Most cases were subclinical, with medications showing no significant impact on thyroid levels.

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    Area of Science:

    • Endocrinology
    • Psychiatry
    • Clinical Biochemistry

    Background:

    • Thyroid dysfunction is common and can mimic psychiatric disorders.
    • Prevalence of thyroid abnormalities in psychiatric inpatients requires further investigation.

    Purpose of the Study:

    • To determine the prevalence of abnormal serum total thyroxine (T4) and triiodothyronine (T3) concentrations in psychiatric inpatients.
    • To assess the clinical presentation and potential influence of psychotropic medications on thyroid hormone levels.

    Main Methods:

    • Serum T4 and T3 levels were measured in 1,206 inpatients across two psychiatric hospitals.
    • Clinical data, including diagnoses and medication use (phenothiazines, benzodiazepines), were collected.
    • Prevalence rates were calculated for hypothyroidism and hyperthyroidism.

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    Main Results:

    • A 0.5% prevalence of primary hypothyroidism (0.5%) and a 0.7% prevalence of clinical hyperthyroidism were observed.
    • Most hypothyroidism cases (5/6) and hyperthyroidism cases (6/8) were subclinical or previously undiagnosed.
    • Phenothiazine and benzodiazepine therapies did not significantly affect thyroid hormone levels.
    • Minor thyroid hormone level variations between psychiatric diagnostic groups were attributed to age distribution differences.

    Conclusions:

    • Subclinical thyroid dysfunction is present in a notable proportion of psychiatric inpatients.
    • Routine thyroid function screening may be beneficial for psychiatric inpatients, especially those with atypical presentations.
    • Psychotropic medications studied do not appear to significantly alter thyroid hormone levels in this population.